Provider Demographics
NPI:1639518228
Name:LOW-T PHYSICIANS OF CALIFORNIA PA
Entity Type:Organization
Organization Name:LOW-T PHYSICIANS OF CALIFORNIA PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:G
Authorized Official - Last Name:REILLY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:877-544-5698
Mailing Address - Street 1:1901 JOHN MCCAIN RD
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-7302
Mailing Address - Country:US
Mailing Address - Phone:817-576-5698
Mailing Address - Fax:817-576-5699
Practice Address - Street 1:1901 JOHN MCCAIN RD
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-7302
Practice Address - Country:US
Practice Address - Phone:817-576-5698
Practice Address - Fax:817-576-5699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty